Returning Students Registration Form 2019-20

Sundays, Pre K -8th Grade: Yearly tuition per child $735No child will be turned away due to lack of funds.

Family Name:*

Student's Name:*

Grade:*In September

Student's Name (2):Child 2

Grade:In September

Student's Name (3):Child 3

Grade:In September

Student's Name: (4)Child 4

Grade:In September

If your child has any allergies and requires an EpiPen, please clickHEREto download a form to be sighed by your Doctor.

As the parent(s) or legal guardian of the above child/ren, I/we authorize any adult acting on behalf of Chabad of Valley Stream Hebrew School to hospitalize or secure treatment for my child/ren, I further agree to pay all charges for that care and/or treatment. It is understood that if time and circumstances reasonably permit, Chabad of Valley Stream Hebrew School personnel will try, but are not required, to communicate with me prior to such treatment. I hereby give permission for my child/ren to participate in all school activities, join in class and school trips on and beyond school properties and allow my child/ren to be photographed while participating in Chabad of Valley Stream Hebrew School activities and that these pictures may be used for marketing purposes. I Accept

Signature*Parent/ Guardian

Considered electronic signature

Tuition: $735 + $100 per family, for an armed security guard

An armed security guard per family*

$100.00

Please choose one of the following payment options:*

One Full tuition payment for one childTwo payments, Today & Jan. 1st, for one childOne Full tuition payment for two childrenTwo payments, Today & Jan. 1st, for two childrenOne Full tuition payment for three childrenTwo payments, Today & Jan. 1st, for three children

Payment*

Credit Card

Credit Card Type

Credit Card Number

Security Code

Name on Card

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Total Tuition

$0.00

I would like to pay today: Full amount$100.00 minimum $

I would like to help cover processing fees by increasing my payment by 3%